<!--
  ========================LICENSE_START=================================
  screenit-web
  %%
  Copyright (C) 2012 - 2020 Facilitaire Samenwerking Bevolkingsonderzoek
  %%
  This program is free software: you can redistribute it and/or modify
  it under the terms of the GNU Affero General Public License as published by
  the Free Software Foundation, either version 3 of the License, or
  (at your option) any later version.
  
  This program is distributed in the hope that it will be useful,
  but WITHOUT ANY WARRANTY; without even the implied warranty of
  MERCHANTABILITY or FITNESS FOR A PARTICULAR PURPOSE.  See the
  GNU General Public License for more details.
  
  You should have received a copy of the GNU Affero General Public License
  along with this program.  If not, see <http://www.gnu.org/licenses/>.
  =========================LICENSE_END==================================
  -->
<html xmlns:wicket>
<wicket:panel>
	<div class="row-fluid koppel-status">
		<fieldset class="hero-unit">
			<form wicket:id="form" class="form-horizontal">				
				<div class="row-fluid">
					<div class="span7">
						<div class="control-group">
							<label class="control-label">AGB-code</label>
							<div class="controls">
								<input type="text" class="input-medium agbCode"
									wicket:id="agbCode">
							</div>
						</div>
					</div>
					<div class="span5">
						<div class="form-actions clearfix">
                            <button wicket:id="submit" type="button" class="btn btn-primary">
								<i class="icon-search icon-white"></i> Zoeken
							</button>
						</div>
					</div>
				</div>
			</form>
		</fieldset>
	</div>
</wicket:panel>
</html>
